Characterisation of heart failure with normal ejection fraction in a tertiary hospital in Nigeria

<p>Abstract</p> <p>Background</p> <p>The study aimed to determine the frequency and characteristics of heart failure with normal EF in a native African population with heart failure.</p> <p>Methods</p> <p>It was a hospital cohort study. Subjects were 177 consecutive individuals with heart failure and ninety apparently normal control subjects. All the subjects underwent transthoracic echocardiography. The group with heart failure was further subdivided into heart failure with normal EF (EF ≥ 50) (HFNEF) and heart failure with low EF(EF <50)(HFLEF).</p> <p>Results</p> <p>The subjects with heart failure have a mean age of 52.3 ± 16.64 years vs 52.1 ± 11.84 years in the control subjects; p = 0.914. Other baseline characteristics except blood pressure parameters and height were comparable between the group with heart failure and the control subjects. The frequency of HFNEF was 39.5%. Compared with the HFLEF group, the HFNEF group have a smaller left ventricular diameter (in diastole and systole): (5.2 ± 1.22 cm vs 6.2 ± 1.39 cm; p < 0.0001 and 3.6 ± 1.24 cm vs 5.4 ± 1.35 cm;p < 0.0001) respectively, a higher relative wall thickness and deceleration time of the early mitral inflow velocity: (0.4 ± 0.12 vs 0.3 ± 0.14 p < 0.0001 and 149.6 ± 72.35 vs 110.9 ± 63.40 p = 0.001) respectively.</p> <p>The two groups with heart failure differed significantly from the control subjects in virtually all echocardiographic measurements except aortic root diameter, LV posterior wall thickness(HFLEF), and late mitral inflow velocity(HFNEF). HFNEF accounted for 70(39.5%) of cases of heart failure in this study.</p> <p>Hypertension is the underlying cardiovascular disease in 134(75.7%) of the combined heart failure population, 58 (82.9%) of the subjects with HFNEF group and 76(71%) of the HFLEF group. Females accounted for 44 (62.9%) of the subjects with HFNEF against 42(39.3%) in the HFLEF group (p = 0.002).</p> <p>Conclusion</p> <p>The frequency of heart failure with normal EF in this native African cohort with heart failure is comparable with the frequency in other populations. These groups of patients are more likely female, hypertensive with concentric pattern of left ventricular hypertrophy.</p

Mitral valve prolapse in Zaria: clinical and echocardiographic features

Background: Mitral valve prolapse (MVP) symptomatology and presentation are said to be of questionable significance. Method: A prospective study of 10 patients with mitral valve prolapse seen at Ahmadu Bello University Hospital in two years. Results: There were six females and four males. Their ages ranged from 5 to 35 years with a mean of 17.80 +/- 10.24. Four patients were suspected as having MVP before the echocardiographic scan (1/3). Six patients (60%) were found to have associated rheumatic heart disease (RHD). The commonest prolapsing leaflet was the anterior mitral valve leaflet found in 80% of the cases. Eight patients (80%) had classical MVP and the remaining two had non-classical MVP. There were significant difference between those with MVP and RHD compared with those without RHD in cardio-thoracic ratio (CTR) and end diastolic volume (EDV). Three patients who had RHD and MVP, had cardiomegaly clinically and on chest radiography. Hypertension and other disorders associated with MVP did not feature in our patient population. Conclusion: Recent reports have highlighted the past over estimation of the syndrome based on ambiguous criteria and use of M-mode echocardiography. The most recent criteria by Freed have put the prevalence at 2.4 %. Key words: Mitral valve, prolapse, features (Annals Af Med: 2002 1(2): 84-91